磷酸钙人工骨在颈椎前路椎间融合治疗颈椎病中的应用

Anterior cervical discectomy and interbody fusion with calcium phosphate cement graft

目的:探讨磷酸钙人工骨在颈椎前路椎间融合治疗颈椎病中的应用效果。方法:2000年9月至2002年9月应用磷酸钙人工骨椎间融合结合钛板颈前路手术治疗41例颈椎病患者,随访32例共48个节段,采用JOA评分判定手术疗效,X线片判定融合效果。结果:随访18.2±7.8个月,全部患者术后未见任何过敏或毒性反应,无皮疹、高热及深部感染。JOA评分从术前10.93±2.48分提高到术后14.54±2.19分(P<0.001)。术后X线片未见人工骨塌陷、移位或脱入椎管,无钛板或螺钉松动及折断。术后48个节段中47个节段获得椎间融合,融合时间15.6±7.4个月。结论:磷酸钙人工骨可替代自体骨应用于颈椎前路椎间融合手术。

Objective:To evaluate the effect of calcium phosphate cement graft in the anterior cervical fusion for cervical spondylosis with anterior instrumentation.Method:32cases were included in this study with48segments.During the procedure the intervertebral disc including chondral end plate were removed and subchondral cortex were partially decorticated.The intervertebral space was distracted and the pre-setted CPC graft was inserted.A Caspar monocortical plate fixation system was implanted.The patients were followed up clinically and radiographically.The mean follow-up time was18.2±7.8months.Result:In all patients,statistical analysis revealed the JOA scores of10.93±2.48and14.54±2.19before operation and at the final examination(P<0.001)respectively.The X-ray film demonstrated that the height of intervertibal space had been restored and there was no loosening of implant and shift of CPC graft.47segments(97.9%)gained solid fusion and the fusion period was15.6±7.4months.Conclusion:The CPC is a very good artificial material as a substitute of autologous bone graft for the anterior cervical interbody fusion.